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Wednesday, November 30, 2016

Women don’t always get what they want from labiaplasty

TheConversation: Labiaplasty is the most common form of female genital cosmetic surgery and involves surgical reduction of the labia minora or the inner lips of the vulva. However we still don’t really know what impact the procedure has on
the lives of women who choose to have it. This is not that surprising
given female genitals are still considered taboo. The words “vulva” and “vagina” are difficult to say for most people, never mind an entire discussion on the topic!
But these questions can be addressed through research. Our latest study
shows although women are pleased with how their genitals look after
labiaplasty, their self-esteem and general sexual confidence do not
improve. This sort of information is vital to help women weigh up
whether labial surgery is the right option for them.

Rising rates of labiaplasty

Labiaplasty has become increasingly popular over the last 10-15 years
in Western countries, including in Australia. From 2001 to 2013, the
number of these procedures more than doubled from 640 to 1,605
in public patients across Australia. These numbers do not include women
undergoing procedures in the private sector, for whom we have no
national data.
In NSW
specifically, numbers in both public and private hospitals rose from
256 in 2001 to 421 in 2013, representing a total increase of 64%.
Although there is a common misconception teenagers are the age group
most interested in labiaplasty, women are most often aged between 25 and 34 when they undergo surgery.

Why do women have ‘the Barbie surgery’?

Although there are physical or functional reasons for having labiaplasty (discomfort participating in sports like cycling or during sexual intercourse), most women do it due to reported unhappiness with their genital appearance. Labiaplasty involves cosmetic reduction of the labia minora that surround the vagina.The Labia Library/Women's Health Victoria
Women desire a smooth genital surface, with labia minora (the inner lips) that do not protrude beyond the labia majora (the outer lips). As a result, this surgery is sometimes nicknamed the “Barbie surgery” as these dolls have no obvious genital features.
The way women’s genitals are portrayed in the media – particularly in pornography and on the internet – may be promoting this “ideal”. And men appear to be picking up on this too, prompting some to criticise
their partner’s genitals. As a result, an increasing number of women
are becoming concerned their genitals are unacceptable and need to be
surgically altered.
But what happens to women after undergoing labiaplasty – do they really get what they were hoping for?

Labiaplasty won’t fix your sex life

In our most recent research published in Plastic and Reconstructive Surgery,
we applied a forward-looking study design to examine psychological
outcomes of labiaplasty. We found women experienced significant
improvements in satisfaction with their genital appearance from pre- to
post-surgery. But we found no significant improvements in any other
psychological domains, such as self-esteem and sexual confidence.
Labiaplasty is often advertised online
as a way for women to restore self-confidence and esteem, and improve
their sexual relationships: our results suggest this is not necessarily
the case. Instead, it appears although labiaplasty allows women to stop
worrying about their genital appearance, it does not radically change
how they view themselves and their intimate relationships.
Our research
was the first to examine preoperative characteristics of women who are
likely to be dissatisfied with their surgical outcomes. We found women
who were more psychologically distressed – showing depression and
anxiety symptoms in particular – or were currently involved in an
intimate relationship were more likely to be dissatisfied after
labiaplasty.
Although further investigation is required, we reasoned these women
may have had unrealistic expectations for how labiaplasty might improve
their psychological well-being or their relationship with their partner,
and when this did not happen, they were dissatisfied.
It’s important for doctors to be able to identify these women before
they undergo labiaplasty so they can be guided into another form of
treatment that may be more beneficial, such as psychological therapy.

Avoiding disappointment after surgery

It looks like most women are getting what they want out of
labiaplasty in terms of becoming more comfortable with their genital
appearance.
But when women have unrealistic expectations for improvements in
other areas of their lives such as their self-esteem and sexual
relationships, they are more likely to be disappointed. For this reason,
we recommend doctors thoroughly explore their patients’ motivations and
expectations for labiaplasty so women can get treatment that will best
address worries about their genital appearance.
Now we’ve started to identify some of the issues related to women’s
dissatisfaction with labiaplasty, we hope our findings might assist
doctors when they’re considering a patient’s suitability for cosmetic
genital surgery.